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Dec 14, 2012
12/12
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regarding health care quality for exchanges on november the 27, it specifically mentions a section, 1311 of aca, which directs quality health plan issues and improvement strategies as directed by the secretary, specifically subsection 8 of 1311 would allow the secretary to prevent physicians treating patients in exchanges unless they implement such mechanisms to improve health care quality the secretary may require. physicians must follow quality directives as defined by the secretary or lose their business. mr. smith, are you aware of this provision? >> i am not familiar with that section. >> let me ask you this. in this provision, you may not know this either, but the word quality is not defined in the statute. it is safe to assume that the secretary, not just secretary sebelius, but every secretary to follow, would be able to define for regulation what that word quality means. yes or no? >> i believe that is the correct interpretation. again, we have tried to introduce quality performances into a variety of parts of our programs, both in managed care, both in the fee-for-service world, and t
regarding health care quality for exchanges on november the 27, it specifically mentions a section, 1311 of aca, which directs quality health plan issues and improvement strategies as directed by the secretary, specifically subsection 8 of 1311 would allow the secretary to prevent physicians treating patients in exchanges unless they implement such mechanisms to improve health care quality the secretary may require. physicians must follow quality directives as defined by the secretary or lose...
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Dec 14, 2012
12/12
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there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor- made renewal system that took years to refine and perfect. the verification system will not be coordinated with other welfare programs creating eligibility verification issues. the mandate says we use the correct coding issues. pennsylvania already performed this task through claim check, a federally approved system that cost pennsylvania $12 million to develop. the new system will be micromanaged by the federal government. the ac man it's we create new transaction methods for verification. our technology is more advanced than what is mandated and nobody
there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor-...
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Dec 29, 2012
12/12
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WMPT
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ven acá ♪ ¿conoces a christian? él también está audicionando ¡estás vestida! no te reconocí ¿qué fue lo que te dijo? nada. ¡oye christian! ♪ ¡oh lo siento! ah... hola ah, kat me trajo pero ya voy a irme. no quédate, soy ethan. lo sé. oye ¿quién es tu amiga? [risa] ¡jo,jo,jo! ¡vaya tú eres ella! ¿quién? tú eres la nueva que se desvistió en el vestuario de chicos. ¡ah-hum! no fue así. fue genial cuando lo supe. ¡kat! yo pensé ¡wow! tú, eres famosa espera yo nunca haría algo así. a propósito las nuevas deberían ser como tú te doy puntos por entusiasmo. ¡ah-hum...! creo que voy a irme [sorprendida] ¡ahhh! [risas] ¡ja,ja,ja! ¿que te he hecho yo? ¡bien hecho kat! ¿qué? ¡ohhh! nunca saldré de esta habitación, no se suponía que fuera así. y... ¿cómo se suponía que fuera? no sé, como un sueño hecho realidad. [risa] ¡ja, ja, ja! es el sueño de todos nadie te lo va regalar. si quieres destacarte tien que probar que eres especial. lo haría, si supiera cómo. puedo enseñarte, ♪ (raine) en la última semana hemos evaluado
ven acá ♪ ¿conoces a christian? él también está audicionando ¡estás vestida! no te reconocí ¿qué fue lo que te dijo? nada. ¡oye christian! ♪ ¡oh lo siento! ah... hola ah, kat me trajo pero ya voy a irme. no quédate, soy ethan. lo sé. oye ¿quién es tu amiga? [risa] ¡jo,jo,jo! ¡vaya tú eres ella! ¿quién? tú eres la nueva que se desvistió en el vestuario de chicos. ¡ah-hum! no fue así. fue genial cuando lo supe. ¡kat! yo pensé ¡wow! tú, eres famosa espera yo nunca...
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Dec 14, 2012
12/12
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the aca contends cost- containment measures by improving care. i was interested in arkansas's payment reform efforts. could you tell us a little bit more about the payment reforms and how they would bring down costs? >> we believe the in arkansas the incentives that we face and the activities we are engaged in in our payment and improvement initiative are aligned with the center for medicare and medicaid innovations. we are engaged in moving away from a fee for service to pay for out comes a denture health care instead of the process that we currently paid for. -- outcomes of in health care instead of the process we currently pay for. we are looking for patience centered care. if we look for that, we are going to have to pay for it. we have not done that in the past. we are engaged and dramatic and sweeping changes working with our private health insurance partners in arkansas. we have worked closely with cms to make the first of these changes, implementing in october for the state plan, not through waiver. it incentivizes for adhd, perinatal car
the aca contends cost- containment measures by improving care. i was interested in arkansas's payment reform efforts. could you tell us a little bit more about the payment reforms and how they would bring down costs? >> we believe the in arkansas the incentives that we face and the activities we are engaged in in our payment and improvement initiative are aligned with the center for medicare and medicaid innovations. we are engaged in moving away from a fee for service to pay for out...
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95
Dec 17, 2012
12/12
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CSPAN2
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. >> but that is the point now that you have the aca that you can have this discussion in a way that was much harder to have before. it is really saying for those who are able to continue working, can we begin to reorient the expectation for the next generation, which is what we're talking about, recognizing that for people who are in that pre now pre-medicare age, they will no longer have to postpone taking care of health care because they, in fact, have an option. so it is why this discussion takes on a whole different tone as a result of the affordable care act having passed. >> i mean, i would say we have options, but we don't know if they're affordable options, and that's really the big difference. >> al milliken, am media. what can we learn from other countries? i'm wondering if any of you have studied the health benefit programs elsewhere, and do any have comparable insurance programs, and what has been the experience in other nations? >> most of them are struggling mightily with the promises they have made which encourage people to retire even earlier than they do in the unit
. >> but that is the point now that you have the aca that you can have this discussion in a way that was much harder to have before. it is really saying for those who are able to continue working, can we begin to reorient the expectation for the next generation, which is what we're talking about, recognizing that for people who are in that pre now pre-medicare age, they will no longer have to postpone taking care of health care because they, in fact, have an option. so it is why this...
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Dec 7, 2012
12/12
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we are trying to do that, in building the aca is important in terms of delivery reforms. pay doctors differ in their rewards quality. we should do that sooner than later. save those dollars sooner. in those discussions, are there other ways that we can see revenues come in from within the health-care system? that is on the table. i am not keen on increasing the age on medicare. we have gone to a really big debate about finding a way to have all americans have health insurance. that is taking a group of americans and figure out how they afford health coverage. that shifts the cost of subsidies and they go into the exchange and make it more expensive for younger people because the older court is in that group. -- cohort is in that group for medicare, these are the least expensive singers we have. the most expensive seniors are much older. you have to look exactly at the consequences and whether that is cost-savings for government and families? >> the president had a firm statement this week to the business roundtable about the debt ceiling where he said, i will not play tha
we are trying to do that, in building the aca is important in terms of delivery reforms. pay doctors differ in their rewards quality. we should do that sooner than later. save those dollars sooner. in those discussions, are there other ways that we can see revenues come in from within the health-care system? that is on the table. i am not keen on increasing the age on medicare. we have gone to a really big debate about finding a way to have all americans have health insurance. that is taking a...